MEDICARE: GAUDENZIA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558352872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAUDENZIA, INC.

Provider Business Mailing Address
First Line	:	106 W MAIN ST
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19401-4716
Country	:	US
Telephone Number	:	610-239-9600
Fax Number	:	610-239-9195

Provider Business Practice Location Address
First Line	:	106 W MAIN ST
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19401-4716
Country	:	US
Telephone Number	:	610-239-9600
Fax Number	:	610-239-9195

Authorized Official
Title or Position	:	DIRECTOR OF FISCAL & CORP OPERATION
Name	:	MR. MICHAEL J. MOYLE
Credential	:	J.D.
Telephone Number	:	610-239-9600

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	02/11/2021

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Directions to “GAUDENZIA, INC. ” Practice Location

Language	Start Address	Practice Location

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